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In 2012, the conventional wisdom among conservatives and Republicans was that the presidential election of that year was of paramount importance. If Mitt Romney didn’t defeat President Obama, Obamacare’s trillions in health care subsidies would go online, and the law would become "impossible to repeal." That was then. Today, repeal remains the official position of the GOP. But Republicans haven't put as much thought into how to address the disruption that a careless version of repeal could incur.

Conservatives in 2013: Obamacare “is here forever”

As recently as last fall, Sen. Ted Cruz (R., Tex.) was asserting that it was critical that Republicans shut down the government to defund Obamacare, because otherwise, repeal would be impossible.

“If we don’t [defund Obamacare] now, in all likelihood, Obamacare, will never, ever be repealed,” Cruz told Sean Hannity in July 2013. “Why is that? Because on January 1 [2014], the exchanges kick in, the subsidies kick in…their plan is to get the American people addicted to the sugar, addicted to the subsidies. And once that happens, in all likelihood, it never gets repealed.“

“It’s over,” Hannity agreed. “It never gets repealed.”

Cruz repeated his assertion a few days later on Hannity’s Fox News show. “We have never undone a major entitlement that has been wound into effect,” he said. “If we’re going to repeal it, we’ve got to do so now, or it will remain with us forever,” he told Fox’s Bret Baier. “If we get to Jan. 1,” Cruz reiterated at an August 2013 Tea Party rally in Texas, “this thing is here forever.”

Cruz and Hannity were drawing from extensive historical experience, and from common sense. The Congressional Budget Office projects that by 2017—the first year in which repeal is even theoretically possible—37 million Americans will be on Obamacare-sponsored health coverage, either through the Medicaid expansion or the exchanges. Now, the CBO’s estimates could very well be too optimistic. And a good chunk of those 37 million had health coverage under the old system. But whatever the exact number, there is a good likelihood that at least 20 million people will be on Obamacare-sponsored insurance plans by 2017.

But now, leading conservative experts believe that Ted Cruz and Sean Hannity are borderline RINOs for being skeptical of post-2014 repeal. “Some of the law’s opponents are reacting to [Obamacare’s progress] with something close to resignation,” complain Jim Capretta and Yuval Levin in the September 22 issue of the Weekly Standard.

Conservatives in 2014: Obamacare repeal is imminent

In their defense, Capretta and Levin aren’t alone. Even Ted Cruz thinks that Ted Cruz is a wuss.

After the defund/shutdown gambit failed, and the sugar addictions had commenced, Cruz reversed himself and began arguing that not only was repeal still possible, but that repeal could happen next year, even without a Republican President. Last March, ABC's Jonathan Karl pressed Cruz on this change. “So you honestly think there is a chance that you could get Obamacare repealed [in 2015], every word, as you say?”

“Every single word,” Cruz replied.

“With Obama in the White House?” said Karl, with growing incredulity.

“You know, what’s funny, Jon, is the media treats that as a bizarre proposition.”

“Well it is. It is a bizarre proposition,” replied Karl.

A popular theory on the right is that conservative politicians get to Washington, start sipping Chardonnay with the media elite at fashionable Georgetown fêtes, and turn left. If 2014 Ted Cruz is right about 2013 Ted Cruz, then Forbesrecommends the 2009 Les Clos Grand Cru from Domaine Drouhin Vaudon for his Chardonnay of choice.

The public opposes repeal by a two-to-one margin

Now, by definition, if Republicans could repeal Obamacare and replace it with something better, that would be an improvement upon the status quo. The problem is that the public, by a two-to-one margin, opposes repeal.

The Kaiser Family Foundation, in its most recent Health Tracking Poll, asked 1,505 adults, “Which would you rather see your representative in Congress do when it comes to the health care law: work to improve the law, or work to repeal the law and replace it with something else?” 63 percent said “improve,” while only 33 percent said “repeal and replace.” Independents opposed repeal 59 to 38; even 40 percent of those who disapproved of Obamacare opposed repeal.

The poll included 1,239 registered voters and 1,056 likely voters. Nate Silver has calculated that polls of all adults and/or registered voters tend to have a Democratic bias of about three percentage points, so take that into account.

Obamacare opponents hope that as the law goes forward, it will become less popular over time. But the likelihood is low that public sentiment will change meaningfully between now and 2016. First of all, polling about Obamacare has been remarkably consistent since the law was passed in 2010. When Kaiser conducted a similar survey in March, it found that adults opposed repeal 59 to 29 percent. More people are likely to be enrolled in Obamacare a year from now, whereas the number of people adversely affected by the law will not increase by as much.

Second of all, the law’s most significant disruptions of the health care market—most notably, its drastic increases in the cost of individually-purchased health insurance—have already taken place. From here on out, the changes will be more incremental.

Enrollment isn’t the only measure of Obamacare’s entrenchment

Most commentators and reporters have focused on the number of sign-ups on the Obamacare exchanges as an indicator of the law’s entrenchment. This is misleading; as noted above, many of those signing up were previously insured, and some who did sign up have since dropped out.

But it’s not just the previously uninsured who have benefited from Obamacare. It’s also the previously insured who are relatively older and sicker. Those individuals now pay meaningfully less for their insurance, because younger and healthier individuals are being forced to pay more to subsidize them. These individuals don’t show up on the official Obamacare statistics, but they will be just as suspicious of repeal as those who lose their coverage altogether.

Republicans must minimize health insurance disruption

This issue of disruption to existing health insurance arrangements is the biggest policy issue with Republicans’ desire to “repeal and replace” Obamacare. Even if the Republican “replace” plan is better than Obamacare, getting from here to there without mass dislocation in the health insurance market is a non-trivial problem.

Jim Capretta and Yuval Levin, for the first time, have attempted to confront this concern in their latest Weekly Standard piece. Obamacare opponents must “refrain…from causing avoidable disruption” in Americans' health coverage, they write:

The president and the law’s supporters may pay a heavy political price this November for breaking their repeated promises not to needlessly disrupt pre-Obama-care insurance arrangements or doctor-patient relationships. The law’s opponents must avoid making the same mistake in their plans to replace Obamacare: They should refrain both from promising that all disruption can be avoided and from causing avoidable disruption. A replacement will need to include a transition—a bridge from Obamacare’s broken architecture to a working health financing system.

This issue of disruption is at the center of my own replacement for Obamacare, which I published through the Manhattan Institute in August. “It is desirable to develop policy proposals that do not require the disruption implied by repeal in order to put U.S. health spending on a sustainable path,” I wrote then.

The problem is that one of the main repeal-and-replace plans that Capretta and Levin endorse—that of the 2017 Project—would heavily disrupt the health-coverage market of 2017. Let's examine four aspects of disruption:

Pre-existing conditions. Obamacare requires insurers to offer coverage to all Americans, regardless of pre-existing conditions, a provision called "guaranteed issue." The 2017 Project plan repeals this provision, instead asking those individuals to enroll in state-run high-risk pools, whose reliability could not be immediately guaranteed. In addition, the economic distortions caused by high-risk pools are at least as great as those caused by guaranteed issue.

Premium subsidies for the near-elderly. The 2017 Project would offer premium subsidies of $900 for those under 18, $1,200 for adults under 35, $2,100 for those between 35 and 50, and $3,000 for those over 50. This change, combined with repeal of age-based community rating, would dramatically increase the net cost of individually-purchased coverage for those over the age of 50, especially those with below-average incomes. (Repealing age-based community rating is a good thing. Capretta and Levin suggest a gradual transition away from age-based community rating, a useful idea in this context.)

Premium subsidies for the poor. The 2017 Project plan does not means-test its premium subsidies. In other words, wealthy people would gain a subsidy they do not need, while low-income individuals would have their subsidies substantially reduced. Aside from the fact that this has no chance of passing Congress, this provision would make it more difficult for low-income individuals to gain coverage.

Americans with health coverage. As a result of these changes, the 2017 Project plan would reduce the number of Americans with health insurance, relative to Obamacare, by 6 million, according to the Center for Health and Economy. This stands in contrast to the repeal-and-replace plan offered by Senators Tom Coburn (R., Okla.), Richard Burr (R., N.C.), and Orrin Hatch (R., Utah), which would increase coverage by 3 million relative to Obamacare, and my “Transcending Obamacare” plan, which would increase coverage by 12 million vs. the ACA.

Some repeal-and-replace plans are better than others

Capretta and Levin believe that "some synthesis [of the 2017 Project and Coburn-Burr-Hatch] will form the starting point for replacing Obamacare," but it's not obvious what the 2017 Project plan brings to the table that should be synthesized with the superior Coburn-Burr-Hatch approach.

The reason that the Coburn-Burr-Hatch plan does better than the 2017 Project plan on coverage expansion is because its premium-subsidy structure is means-tested, as Obamacare's is. As I mentioned above, the 2017 Project insists on offering premium subsidies to the wealthy and cutting them for the poor. If that's what its authors consider a "winning alternative to Obamacare," I have a bridge I'd like to sell them.

There are other fatal flaws in the 2017 Project proposal, most notably its opposition to Medicare reform. But the core problem with it is that it’s more of an exercise in political trolling than in real health policy. It has some good aspects, like its reforms of the employer tax exclusion, and its use of tax credits to subsidize coverage for the uninsured.

The 2017 Project plan doesn’t confront the worst distortions of government-run health care, and it’s not designed to. It’s designed to repeal Obamacare, while politically insulating Republicans from the charge that they lack sympathy for the uninsured. But by failing to persuade voters of the latter, it will fail to achieve the former as well.

It’s time for the GOP to do the heavy lifting on health reform

The enormous size and scale of the U.S. government is due entirely to the fact that it spends more than a trillion dollars a year—excluding Obamacare—on health insurance. The 2017 Project plan ignores this problem. Better plans, like Coburn-Burr-Hatch, tackle these issues head-on, by incorporating those senators’ previous work on health-entitlement reform.

If the GOP is serious about making the health care system better for all Americans, while also making it fiscally sustainable, it’ll have to come up with a proposal that replaces not just Obamacare, but also reforms Medicare, Medicaid, and the rest. And if Republicans want public support for their reforms, they’ll have to come up with a way to truly minimize the degree to which their plan disrupts Americans’ existing coverage arrangements. That’s no easy task. I root for their success.

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UPDATE: An earlier version of this article gave the incorrect impression that Capretta and Levin prefer the 2017 Project plan over the Coburn-Burr-Hatch proposal; more precisely, they have advocated a "synthesis" of the two.

INVESTORS’ NOTE: The biggest publicly-traded players in Obamacare’s health insurance exchanges are Aetna (NYSE:AET), Humana (NYSE:HUM), Cigna (NYSE:CI), Molina (NYSE:MOH), WellPoint (NYSE:WLP), and Centene (NYSE:CNC), in order of the number of uninsured exchange-eligible Americans for whom their plans are available.